Dentists Say Severe Tooth Decay in Preschoolers is Widespread Epidemic
The Centers for Disease Control and Prevention has noted that, for the first time in 40 years, the number of preschoolers with multiple cavities is on the rise. Dentists are noting young kids with as many as six to 10 cavities in baby teeth and the level of decay is so severe that the children require anesthesia in order to sit through extensive procedures to repair them.
In February, a month set aside to raise awareness for children’s dental health, the American Academy of Pediatric Dentistry launched a campaign to remind parents that dental and oral care starts early – even before children get their first teeth or reach their first birthday. However, the New York Times reports that some parents have not yet received the message.
Reporter Catherine Saint Louis tells the story of Devon Koester, a 2 ½ year old from Stanwood, Washington who had 11 cavities in his 20 baby teeth. The procedures to fix the decay included extraction of two incisors, a root canal and several fillings and crowns. Devon’s mother said that they had not worried about brushing their son’s teeth until he was 18 months old and they noticed they were discolored. “I had a lot on my mind, and brushing his teeth was an extra thing I didn’t think about at night,” she said.
Mrs. Koester’s story isn’t unlike what dentists are seeing around the country. The number of preschoolers that require this type of extensive dental work suggests that many other parents are making the same mistakes.
“We have had a huge increase in kids going to the operating room,” said Dr. Jonathan Shenkin, a pediatric dentist and a spokesman for the American Dental Association. “We’re treating more kids more aggressively earlier.” He notes that parents tell him that they weren’t aware that dental care started so early.
Other issues include excessive snacking, sugary beverages, bottles or sippy cups with drinks other than water at bedtime, and a lack of fluoridation use.
Behavioral issues can also be to blame. When toddlers express dislike for the tooth-brushing experience, some parents won’t enforce it. But parents should think about it this way, says Dr. Jed Best, a pediatric dentist in Manhattan. “I’d much rather have a kid cry with a soft toothbrush than when I have to drill a cavity.”
Dental decay on its own is a serious health issue. Decay in baby teeth can affect the adult teeth growing underneath. Plus, if a child has to have anesthesia for extensive work, risks include nausea and vomiting, and a rare possibility of brain damage. The use of anti-anxiety drugs carries a potential risk of breathing problems.
Also, the cost of dental work is not an insignificant factor to keep in mind. Most dental insurance plans do not cover 100% of the charges, so parents are often left with a hefty bill – much more than the cost of a toddler toothbrush and kid-friendly toothpaste.
The dentists involved with the New York Times review offer the following tips for Healthy Baby Teeth:
• Take an infant to a dentist before the first birthday for an assessment of cavity risk, even if the child has only a few teeth.
• In general, brush the teeth of children 2 or younger with a bit of fluoride toothpaste twice a day. At 2, start to use a pea-size dollop.
• Reduce snacking. Eating any starchy or sugary food causes the pH level in the mouth to drop sharply, leaving teeth awash in an acid bath — murder on enamel — for 20 minutes until saliva normalizes the pH. The frequency of exposure to acid is more important than the sugar content of food.
• Skip the “gummy” treats (ie Fruit snacks, fruit roll-ups) which stick to the teeth, exposing them much longer. Also, even though the kids like the gummy vitamins better, they are not good for the teeth, says Dr. Michele Boyne, a pediatric dentist in South Carolina.
• After eating a sugary snack or drinking a juice or soda beverage, brush your child’s teeth afterward.
• Do not share utensils with a child or “clean” a pacifier in your mouth, then give it to your infant. Research has shown that parents or caregivers with active tooth decay can pass cavity-causing bacteria via saliva.
• Brush preschoolers’ teeth for them. “They are not in a position to effectively brush their teeth until they are 7 or 9,” said Dr. John Hanna, the director at the pediatric dental surgery clinic at Oregon Health and Science University in Portland.